Provider Demographics
NPI:1114003522
Name:SKELTON, JANICE (ND)
Entity type:Individual
Prefix:DR
First Name:JANICE
Middle Name:
Last Name:SKELTON
Suffix:
Gender:F
Credentials:ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1104 E CHARLESTON AVE
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85022-1146
Mailing Address - Country:US
Mailing Address - Phone:602-317-1277
Mailing Address - Fax:
Practice Address - Street 1:1104 E CHARLESTON AVE
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85022-1146
Practice Address - Country:US
Practice Address - Phone:602-317-1277
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ04-795175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath